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Original article Contrasting income-based inequalities in incidence and mortality of breast cancer in South Korea, 2006–2015
Jinwook Bahk1orcid , Hee-Yeon Kang2orcid , Young-Ho Khang3orcid , Kyunghee Jung-Choi4orcid
Epidemiol Health 2024;e2024074
DOI: https://doi.org/10.4178/epih.e2024074 [Accepted]
Published online: September 11, 2024
1Department of Public Health, Keimyung University, Daegu, Korea
2Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Korea
3Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, Korea
4Department of Environmental Medicine, College of Medicine, Ewha Womans University, Seoul, Korea
Corresponding author:  Kyunghee Jung-Choi,
Email: jungchoi@ewha.ac.kr
Received: 3 June 2024   • Revised: 13 August 2024   • Accepted: 14 August 2024
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Abstract

OBJECTIVES
Breast cancer incidence and mortality rates in Korea are increasing. This study analyzed income-based inequalities in the incidence and mortality of female breast cancer from 2006 to 2015, using national data that covered all Korean women.
METHODS
We used the National Health Information Database from 2006 to 2015. For women aged 20 and older, the age-standardized incidence and mortality rates of breast cancer per 100,000 by income quintile per year were calculated using the direct method. The rate ratio and rate difference (RD) of the age-standardized incidence and mortality rates of breast cancer per 100,000 between the top and bottom income quintiles were calculated as relative and absolute measures for inequalities.
RESULTS
When comparing 2006 and 2015, both the incidence and mortality rates of breast cancer increased. The lowest income quintile experienced higher mortality rates despite having lower incidence rates. In 2015, the income-based relative difference (RD) in incidence and mortality rates between the highest and lowest income quintiles (Q1-Q5) was -19.9 (95% CI, -24.3 to -15.5) and 4.4 (95% CI, 2.9 to 5.8), respectively. Throughout this period, there was no statistically significant trend in income-based disparities in breast cancer incidence and mortality. The age-specific contributions to the absolute magnitude of inequality (RD) in incidence and mortality were more pronounced among middle-aged women than among older women.
CONCLUSIONS
This study found that breast cancer in Korea exhibited pro-rich inequalities in mortality despite pro-poor inequalities in incidence. More equitable policies for screening and treatment of breast cancer are needed.

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